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Using the information provided below, which statement is TRUE: HCC Question Practice test #1.png  

Which risk adjustment model is used by Medicaid programs?

Retrospective audits should include the following attributes: I. Provider signatures II. Supporting documentation of the patient’s diagnoses III. DOS

Which of the following are reported by a provider for beneficiaries in a Medicare Advantage Plan?  I. Nature of the presenting problem II. Resolved conditions that have been treated in the past III. Family history for all conditions IV. All chronic conditions

Predictive models are used to identify people who are at high risk of chronic illnesses having higher medical claims; what can a provider do with this information to decrease the medical costs? I. Develop disease management education programs II. Involve clinical staff to help with coordination of care III. Refer the patients with chronic illnesses to be treated by another provider IV. Determine the return on investment when referring to a specialist for chronic illnesses

Name the part indicated by the Black arrow  

Which of the following general statements is NOT TRUE regarding Risk Adjustment practices and Quality? 

Today a 54-year-old man presents for his routine follow up after renal transplant two years ago. The patient has CKD stage 2 and reports no other complaints. Assign the correct ICD-10-CM code(s).

Name the part indicated by the blue square

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